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. 2021 Jul:6:100120.
doi: 10.1016/j.lanepe.2021.100120. Epub 2021 May 19.

COVID-19 outbreaks following full reopening of primary and secondary schools in England: Cross-sectional national surveillance, November 2020

Felicity Aiano  1 , Anna A Mensah  1 , Kelsey McOwat  1 , Chinelo Obi  1 , Amoolya Vusirikala  1 , Annabel A Powell  1 , Jessica Flood  1 , Johanna Bosowski  1 , Louise Letley  1 , Samuel Jones  1 , Zahin Amin-Chowdhury  1 , Joanne Lacy  1 , Iain Hayden  1 , Sharif A Ismail  2 , Mary E Ramsay  1 , Shamez N Ladhani  1   3 , Vanessa Saliba  1
Affiliations

COVID-19 outbreaks following full reopening of primary and secondary schools in England: Cross-sectional national surveillance, November 2020

Felicity Aiano et al. Lancet Reg Health Eur. 2021 Jul.

Abstract

Background: The full reopening of schools in September 2020 was associated with an increase in COVID-19 cases and outbreaks in educational settings across England.

Methods: Primary and secondary schools reporting an outbreak (≥2 laboratory-confirmed cases within 14 days) to Public Health England (PHE) between 31 August and 18 October 2020 were contacted in November 2020 to complete an online questionnaire.

Interpretation: There were 969 school outbreaks reported to PHE, comprising 2% (n = 450) of primary schools and 10% (n = 519) of secondary schools in England. Of the 369 geographically-representative schools contacted, 179 completed the questionnaire (100 primary schools, 79 secondary schools) and 2,314 cases were reported. Outbreaks were larger and across more year groups in secondary schools than in primary schools. Teaching staff were more likely to be the index case in primary (48/100, 48%) than secondary (25/79, 32%) school outbreaks (P = 0.027). When an outbreak occurred, attack rates were higher in staff (881/17,362; 5.07; 95%CI, 4.75-5.41) than students, especially primary school teaching staff (378/3852; 9.81%; 95%CI, 8.90-10.82%) compared to secondary school teaching staff (284/7146; 3.97%; 95%CI, 3.79-5.69%). Secondary school students (1105/91,919; 1.20%; 95%CI, 1.13-1.28%) had higher attack rates than primary school students (328/39,027; 0.84%; 95%CI, 0.75-0.94%).

Conclusions: A higher proportion of secondary schools than primary schools reported a COVID-19 outbreak and experienced larger outbreaks across multiple school year groups. The higher attack rate among teaching staff during an outbreak, especially in primary schools, suggests that additional protective measures may be needed.

Funding: PHE.

Keywords: COVID-19; Children; Outbreak; SARS-CoV-2; Schools; Transmission.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
COVID-19 outbreaks by region that were (A) reported and (B) investigated by Public Health England during the first half of the autumn term (31 August to 18 October 2020) in England.Some outbreaks reported to PHE as occurring in primary or secondary schools were subsequently identified as combined schools that hosted both primary and secondary schools on the same site, which were excluded from further analyses.
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